Importance of Not Ignoring Symptoms

This article discusses the importance of not ignoring symptoms of cancer and to discuss the possible consequences of this.  There are many reasons why someone would ignore key “red flag” symptoms of cancer.  Some of the more common reasons include:

  • Denial – Simply ignoring the possibility of bad news is a common coping strategy.  Denial is often the first way that most people deal with very bad news (i.e. “No, it can’t be true”).  The person usually understands that something is truly wrong but chooses to consciously ignore it.
  • Financial worry – Sometimes, particularly in elderly people who have little resources, the thought of expensive testing and mediations is frightening.  Often these fears are unfounded and this type of decision is made without enough information.  There are many types of assistance available in the United States to get life-saving medical care even to those without enough money to afford care or insurance.
  • Magical thinking – In a child-like way some people think that if they do not say the name of a disease or admit to having the problem that it will magically disappear.  This type of thinking is sometimes a culturally ingrained sentiment.
  • Supernatural belief – Most people admit to a belief in God and faith of some sort.  Some will quickly write off a concerning symptom with a belief that “God will heal me.”  There is certainly nothing wrong with a belief in God however to entirely ignore symptoms and not take advantage of modern medical care is quite a risky proposition.
  • Fear of treatment – Some will avoid seeking treatment for a concerning symptom because they may have had a friend or family member experience bad complications.  Often these fears are unfounded and simply you need reliable information.  It is quite possible that the presumed cancer symptom is not cancer at all and the persons need reassurance.  Modern medical care has many tools to alleviate discomfort from testing or treatment and to treat pain from cancer.
  • Ignorance – It is possible that someone might ignore a red flag symptom simply because they do not realize the significance of it.  If someone loses 20 pounds unintentionally and has frequent blood in the stool this would be hard to ignore for most people.
  • Embarrassment–Many types of cancer symptoms involve very sensitive areas and create a feeling of embarrassment.  Having pain or bleeding with bowel movements is not something that most people are apt to discuss.  Unfortunately, this embarrassment might be a significant source of delay in diagnosis or treatment.
  • Stigma – Some cultures believe that getting cancer is a reflection on the morals of the family or represents a magical type of curse.  The facts are that most cancer is known to be based upon faulty DNA repair genes and are not a reflection of someone’s character.

There are certain “red flag” cancer symptoms that would prompt (or should prompt) most people to seek medical care.  While there are many types of cancers, some of the more common “red flag” symptoms that should not be ignored include:

  • Unintentional Weight loss – common with many cancers especially pancreatic and colon cancer, many causes NOT related to cancer such as infections or inflammatory bowel disease.
  • Pain that will not go away – When cancers invade or press on surrounding structures they often cause some degree of pain or discomfort.  There are many types of pains that are not cancer for example the vast majority of breast pain is NOT cancer but mastalgia related to menstrual cycle or fibrocystic changes.
  • Fevers that are persistent – Cyclic fevers are common with Lymphoma but fevers can be caused by many things NOT cancer such as infections.
  • Unrelenting Cough – A common complaint with lung cancer but can be seen with many things NOT cancer such as asthma or bronchitis or COPD.
  • Bloody Cough on several occasions – Lung cancer can cause bloody cough (hemoptysis) but many things NOT cancer can cause blood in the cough such as bronchitis.
  • Blood in the stool on several occasions – Blood in the stool whether dark or bright should never be ignored.  The chance of having a cancer of the intestine with blood in the stool depends upon age and risk factors but may be as high as 30% in some populations.  There are many causes of blood in the stool that are NOT cancer such as diverticulosis, angiodysplasia or ulcer disease.
  • A new “Lump” – In general a newly found lump (mass or tumor are terms used interchangeably as well) should not be ignored.  Some common types of cancer “lumps” are lymphoma, breast tumors, and soft tissue sarcomas.  There are many lumps that are NOT cancer such as lipoma (fatty tumors that are benign) and cysts (fluid filled collections on the body).
  • A changing skin mole – A change in a skin mole deserves examination and likely biopsy by your doctor.  There are many types of skin lesions that are NOT cancer such as actinic keratosis but they require a trained eye to recognize.
  • Jaundice (not in a newborn) – There are many causes of jaundice (yellowing of the skin or even an orange appearance) that are NOT cancer such as gallstone disease but some cancers such as the pancreatic cancer can cause jaundice.

There are many different kinds of cancers but the above nine symptoms or findings will allow recognition of most of them.  Several points should be mentioned about this list that serve as both disclaimers and modifiers.  The specificity of these symptoms is not 100% and the presence of any of these symptoms is NOT a diagnosis of cancer.  It is possible to have unrelenting cough from asthma as well as being caused by lung cancer.  Fevers can be caused by infections as well as some types of cancers, and etc.  The other point is that by the time a cancer causes severe symptoms, this often means it has been present for some time and has had time to spread to others areas or invade surrounding structures.  A cancer that has spread is much harder to treat and has a very poor chance of being cured.  This being said there are many excellent treatment plans available for most cancers that have good response rates with potential for cure.  Ignoring these symptoms may miss a window of opportunity for cure.

REFERENCES:

  1. www.cancer.gov/global/web/faq
  2. Abeloff, M.D. (2008). Abeloff: Abeloff’sClinical  Oncology, 4th ed. Chapter 1. Philadelphia, PA: Churchill Livingstone – Elsevier
  3. Diagnosing cancer in the symptomatic patient. Salzman BE, Lamb K, Olszewski RF, Tully A, Studdiford J. Prim Care. 2009 Dec;36(4):651-70; table of contents. Review. PMID:  19913180
  4. This article was originally published on September 3, 2012 and last revision and update was 9/4/2015.